Healthcare Operations (HCO)
Job ID 27274
- Experience 2 Years
- Gender Any
- Qualifications Graduate
The Purpose of This Role
The Healthcare Operations (HCO) leads and administers a range of Health and Benefits for corporate clients. Participants are the employees of clients who are eligible to enroll in Health & Welfare (H&W) benefits such as Medical, Dental, Vision, Prescription Drugs, Life Insurance etc. The HCO DXO team and its’ associates are responsible for transmitting (either electronically or through the mode agreed with client) participants data i.e. Enrollment, Elections, Coverage Details and any changes to participant data such as demographics, employment information, premiums and payroll deductions to different parties such as Participants, Carriers, Clients and Vendors. The role requires to work on transaction processing, modifying, checking and sending accurate data to clients per transmission schedule.
The Value You Deliver
• The associate will be servicing and supporting our customers by analyzing and checking data files. The associate will be using customized technical tools, procedures in identifying errors and rely on their decision to work on data when rectifications are required.
• The associate will be assuring the H&W interface files are completed on time and accurate as per plan rules & established procedures based on data from recordkeeping systems by following file processing workflow and correcting files as mentioned in requirements.
• The associate will be representing the file processing process to the key partners. Also they will be finding any opportunities to gain efficiency through improvements in process.
• The associate will be adhering to and be accountable for maintaining utilization, efficiency, quality, and control standards.
• The associate will be proactively working with the leads to help track progress & health of the process, addressing issues and recommending course corrections as and when needed.
• The associate will be responsible to lead multiple clients which are identified as highly critical.
The Skills that are Key to this role
• Adequate computing skills including excellent command over MS Office Suite
• Knowledge of query building/data mining in MS ACCESS; experience in working on ERP is preferred
• Proactive problem solving, issue resolution, research, analysis, reasoning & analytical abilities
• Expertise in detailed and procedural documentation, email & general writing skills and satisfactory familiarity with analyzing, referring, representing and visualizing data
• High integrity and discretion to ensure the confidentiality of critical client data handled by you
• Attention to details, creative and business critical thinking
• Ability to identify potential issues, concerns, evaluate and implement risk mitigation strategies
• To prioritize multiple tasks and follow through on your assignments
• Flexible to adapt in today’s constantly evolving business needs
• Dynamic attitude towards work with positive energy and passion to learn new things The Skills that are Good To Have for this role
• Excellent English verbal, written and social skills
• US Employee Benefits administration domain knowledge would be an advantage
• Healthcare and Insurance/ Claims processing experience would be the plus
The Expertise We’re Looking For
• 2 – 5 years’ experience in Operations, BPO, KPO in IT industry
• Bachelor’s degree
• Flexible to work in any shifts (including night shifts, if required)